Postoperative Chemotherapy Bladder Instillation After Radical Nephroureterectomy: Results of a European Survey from the Young Academic Urologist Urothelial Cancer Group
Background: Level 1 evidence supports the administration of single postoperative intravesical chemotherapy (pIVC) following radical nephroureterectomy (RNU) for upper tract urothelial carcinoma (UTUC), in order to decrease intravesical recurrence risk. Objective: The Young Academic Urologist Urothel...
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Elsevier
2020-12-01
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language |
English |
format |
Article |
sources |
DOAJ |
author |
Tom-Régis Dobé Gianluigi Califano Friedrich-Carl von Rundstedt Idir Ouzaid Simone Albisinni Atiqullah Aziz Ettore Di Trapani Kees Hendricksen Wojciech Krajewski Andrea Mari Marco Moschini Andrea Necchi Aidan P. Noon Cedric Poyet Benjamin Pradère Michael Rink Florian Roghmann Paul Sargos Roland Seiler Francesco Soria Malte W. Vetterlein Evanguelos Xylinas |
spellingShingle |
Tom-Régis Dobé Gianluigi Califano Friedrich-Carl von Rundstedt Idir Ouzaid Simone Albisinni Atiqullah Aziz Ettore Di Trapani Kees Hendricksen Wojciech Krajewski Andrea Mari Marco Moschini Andrea Necchi Aidan P. Noon Cedric Poyet Benjamin Pradère Michael Rink Florian Roghmann Paul Sargos Roland Seiler Francesco Soria Malte W. Vetterlein Evanguelos Xylinas Postoperative Chemotherapy Bladder Instillation After Radical Nephroureterectomy: Results of a European Survey from the Young Academic Urologist Urothelial Cancer Group European Urology Open Science Upper tract urothelial carcinoma Single intravesical postoperative instillation Chemotherapy Intravesical recurrence Radical nephroureterectomy |
author_facet |
Tom-Régis Dobé Gianluigi Califano Friedrich-Carl von Rundstedt Idir Ouzaid Simone Albisinni Atiqullah Aziz Ettore Di Trapani Kees Hendricksen Wojciech Krajewski Andrea Mari Marco Moschini Andrea Necchi Aidan P. Noon Cedric Poyet Benjamin Pradère Michael Rink Florian Roghmann Paul Sargos Roland Seiler Francesco Soria Malte W. Vetterlein Evanguelos Xylinas |
author_sort |
Tom-Régis Dobé |
title |
Postoperative Chemotherapy Bladder Instillation After Radical Nephroureterectomy: Results of a European Survey from the Young Academic Urologist Urothelial Cancer Group |
title_short |
Postoperative Chemotherapy Bladder Instillation After Radical Nephroureterectomy: Results of a European Survey from the Young Academic Urologist Urothelial Cancer Group |
title_full |
Postoperative Chemotherapy Bladder Instillation After Radical Nephroureterectomy: Results of a European Survey from the Young Academic Urologist Urothelial Cancer Group |
title_fullStr |
Postoperative Chemotherapy Bladder Instillation After Radical Nephroureterectomy: Results of a European Survey from the Young Academic Urologist Urothelial Cancer Group |
title_full_unstemmed |
Postoperative Chemotherapy Bladder Instillation After Radical Nephroureterectomy: Results of a European Survey from the Young Academic Urologist Urothelial Cancer Group |
title_sort |
postoperative chemotherapy bladder instillation after radical nephroureterectomy: results of a european survey from the young academic urologist urothelial cancer group |
publisher |
Elsevier |
series |
European Urology Open Science |
issn |
2666-1683 |
publishDate |
2020-12-01 |
description |
Background: Level 1 evidence supports the administration of single postoperative intravesical chemotherapy (pIVC) following radical nephroureterectomy (RNU) for upper tract urothelial carcinoma (UTUC), in order to decrease intravesical recurrence risk. Objective: The Young Academic Urologist Urothelial Cancer Group aimed to investigate the use of pIVC in daily practice among European colleagues. Design, setting, and participants: An online survey was shared with European Association of Urology Section of Oncological Urology (ESOU) 2017 participants via e-mail. Submissions were accepted from April to June 2017. The topics for 15 questions of this survey included the habit of delivering pIVC, the choice of drug, its dosage, related doubts or concerns, reasons not to perform pIVC, knowledge of the evidence, and surgical preferences for RNU. Outcome measurements and statistical analysis: Survey software was used for analyses. Logistic regression analyses were used to investigate the association between surgeons’ experience and caseloads with pIVC utilization. Results and limitations: Overall, 127 responses were collected (11.6%). About half of the participants (47%) regularly administered pIVC following RNU. The drug most commonly utilized was mitomycin (85%); 82% adhered to the standard dosage of 40 mg. Different administration protocols were adopted: ≤48 h (39%), 7–10 postoperative days (35%), >10 d (11%), and intraoperatively (10%). The evidence was supported by prospective randomized clinical trials for only 65% of responders. Among interviewees who did not deliver pIVC, the most commonly reported reasons were lack of supporting data (55%), fear of potential side effects (18%), and organizational hurdles (15%). Conclusions: Our research highlights the limited use of pIVC following RNU for UTUC, raising the question of how the compliance with level 1 evidence in the urological community may be promoted. Patient summary: Level 1 evidence supports the administration of single postoperative intravesical chemotherapy (pIVC) following radical nephroureterectomy (RNU) for upper tract urothelial carcinoma (UTUC), in order to decrease intravesical recurrence risk. The Young Academic Urologist Urothelial Cancer Group aimed to investigate the use of pIVC in daily practice among European colleagues. Our research highlights the limited use of pIVC (47%) following RNU for UTUC, raising the question of how the compliance with level 1 evidence in the urological community may be promoted. |
topic |
Upper tract urothelial carcinoma Single intravesical postoperative instillation Chemotherapy Intravesical recurrence Radical nephroureterectomy |
url |
http://www.sciencedirect.com/science/article/pii/S266616832035847X |
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doaj-5522d8fd6fce42a3b668c96083882d172020-12-30T04:23:01ZengElsevierEuropean Urology Open Science2666-16832020-12-01224550Postoperative Chemotherapy Bladder Instillation After Radical Nephroureterectomy: Results of a European Survey from the Young Academic Urologist Urothelial Cancer GroupTom-Régis Dobé0Gianluigi Califano1Friedrich-Carl von Rundstedt2Idir Ouzaid3Simone Albisinni4Atiqullah Aziz5Ettore Di Trapani6Kees Hendricksen7Wojciech Krajewski8Andrea Mari9Marco Moschini10Andrea Necchi11Aidan P. Noon12Cedric Poyet13Benjamin Pradère14Michael Rink15Florian Roghmann16Paul Sargos17Roland Seiler18Francesco Soria19Malte W. Vetterlein20Evanguelos Xylinas21Urology Department, Bichat-Claude Bernard Hospital, Assistance-Publique Hôpitaux de Paris, Paris University, Paris, FranceUrology Department, Bichat-Claude Bernard Hospital, Assistance-Publique Hôpitaux de Paris, Paris University, Paris, France; Urology Unit, Department of Neurosciences, Reproductive Sciences and Odontostomatology, Federico II University of Naples, Naples, ItalyUrology Department, Helios University Hospital Wuppertal, University of Witten/Herdecke, GermanyUrology Department, Bichat-Claude Bernard Hospital, Assistance-Publique Hôpitaux de Paris, Paris University, Paris, FranceUrology Department, Erasme Hospital, Université Libre de Bruxelles, Brussels, BelgiumUrology Department, München Klinik Bogenhausen, Munich, GermanyUrology Department, European Institute of Oncology, Milan, ItalyUrology Department, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The NetherlandsDepartment of Urology and Oncological Urology, Wrocław Medical University, Wrocław, PolandUrology Department, Careggi Hospital, University of Florence, Florence, ItalyUrology Department, Luzerner Kantonsspital, Lucerne, SwitzerlandDepartment of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, ItalyUrology Department, Sheffield Teaching Hospitals NHS Trust, Sheffield, UKUrology Department, University Hospital Zürich, University of Zürich, Zürich, SwitzerlandUrology Department, University Hospital of Tours, Tours, FranceUrology Department, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyUrology Department, Ruhr-University Bochum, Marien Hospital, Henre, GermanyDivision of Radiation Oncology, Department of Oncology, McGill University, Montreal, QC, CanadaDepartment of Urology, University Hospital Bern, Bern, SwitzerlandUrology Division, Department of Surgical Sciences, University of Studies of Torino, Turin, ItalyUrology Department, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyUrology Department, Bichat-Claude Bernard Hospital, Assistance-Publique Hôpitaux de Paris, Paris University, Paris, France; Corresponding author. Urology Department, Bichat-Claude Bernard Hospital, Assistance-Publique Hôpitaux de Paris, Paris University, Paris, France. Tel. +33 1 40 25 71 02.Background: Level 1 evidence supports the administration of single postoperative intravesical chemotherapy (pIVC) following radical nephroureterectomy (RNU) for upper tract urothelial carcinoma (UTUC), in order to decrease intravesical recurrence risk. Objective: The Young Academic Urologist Urothelial Cancer Group aimed to investigate the use of pIVC in daily practice among European colleagues. Design, setting, and participants: An online survey was shared with European Association of Urology Section of Oncological Urology (ESOU) 2017 participants via e-mail. Submissions were accepted from April to June 2017. The topics for 15 questions of this survey included the habit of delivering pIVC, the choice of drug, its dosage, related doubts or concerns, reasons not to perform pIVC, knowledge of the evidence, and surgical preferences for RNU. Outcome measurements and statistical analysis: Survey software was used for analyses. Logistic regression analyses were used to investigate the association between surgeons’ experience and caseloads with pIVC utilization. Results and limitations: Overall, 127 responses were collected (11.6%). About half of the participants (47%) regularly administered pIVC following RNU. The drug most commonly utilized was mitomycin (85%); 82% adhered to the standard dosage of 40 mg. Different administration protocols were adopted: ≤48 h (39%), 7–10 postoperative days (35%), >10 d (11%), and intraoperatively (10%). The evidence was supported by prospective randomized clinical trials for only 65% of responders. Among interviewees who did not deliver pIVC, the most commonly reported reasons were lack of supporting data (55%), fear of potential side effects (18%), and organizational hurdles (15%). Conclusions: Our research highlights the limited use of pIVC following RNU for UTUC, raising the question of how the compliance with level 1 evidence in the urological community may be promoted. Patient summary: Level 1 evidence supports the administration of single postoperative intravesical chemotherapy (pIVC) following radical nephroureterectomy (RNU) for upper tract urothelial carcinoma (UTUC), in order to decrease intravesical recurrence risk. The Young Academic Urologist Urothelial Cancer Group aimed to investigate the use of pIVC in daily practice among European colleagues. Our research highlights the limited use of pIVC (47%) following RNU for UTUC, raising the question of how the compliance with level 1 evidence in the urological community may be promoted.http://www.sciencedirect.com/science/article/pii/S266616832035847XUpper tract urothelial carcinomaSingle intravesical postoperative instillationChemotherapyIntravesical recurrenceRadical nephroureterectomy |